Wrist MR Arthrography: How, Why, When

Cerezal, Luís; Abascal, Faustino; García-Valtuille, Roberto; Piñal, Francisco del

doi:10.1016/j.rcl.2005.02.004

Cited by 87 publications

(94 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MR imaging has the advantage that indirect signs of chronicity may be seen in the ulnar corners of the lunate, as a sign of ulnocarpal abutment, as opposed to arthrography, which does not have this advantage. However, it is difficult to differentiate between a degenerative tear and a traumatic tear using MR imaging (3,11). Moreover, it has been reported in the literature that both MR imaging and conventional arthrography are of limited value for the localization of TFC defects, particularly those of the ulnar side (7,10,13,16).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the triangular fibrocartilage in cadaveric wrists by means of arthrography, magnetic resonance (MR) imaging, and MR arthrography

et al. 2007

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of the triangular fibrocartilage in cadaveric wrists by means of arthrography, magnetic resonance (MR) imaging, and MR arthrography

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Cerezal et al [11] recommended performing triple compartment MRA in patients with chronic pain of unclear origin or instability of the wrist. In cases of suspected TFCC or intrinsic ligament lesions, the authors use conventional MR imaging with radiocarpal MRA.…”

Section: Discussionmentioning

confidence: 99%

“…A number of authors advocate using CT arthrography (CTA) for the assessment of SLL and LTL tears [11,43,48,60]. Schmid et al [43] compared CTA to standard MRI for the evaluation of SLL and LTL tears and found that CTA is also able to evaluate the different ligament segments individually and was superior to MR imaging in the detection of dorsal segment tears.…”

Section: Discussionmentioning

confidence: 99%

MR Arthrography of the Wrist: Controversies and Concepts

Maizlin¹,

Brown

Clement

et al. 2008

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Magnetic resonance arthrography (MRA) has become the preferred modality for imaging patients with internal derangement of the wrist. However, several aspects of MRA use need to be clarified before a standardized approach to the imaging of internal derangement of the wrist can be developed. The objective of the study is to evaluate the efficiency of different magnetic resonance (MR) sequences in the detection of lesions of the triangular fibrocartilage complex (TFCC) and scapholunate and lunotriquetral ligaments on direct MRA. Thirty-one consecutive direct magnetic resonance arthrographic examinations of the wrist using a wrist surface coil were performed for the assessment of the TFCC and intrinsic ligaments on a 1.5-T MR imaging system (Signa; 16 channel, Excite, GE Healthcare, Milwaukee, WI, USA). All patients had wrist pain, and in six cases, there was associated clinical carpal instability. The presence, location, and extent of TFCC, scapholunate ligament (SLL), and lunotriquetral ligament (LTL) lesions on T1 fat-saturated, multiplanar gradient recalled (MPGR) and short tau inversion recovery (STIR) images were identified, compared, and analyzed. Forty-one lesions of the TFCC, SLL, and LTL were visualized on contrast-sensitive (T1 fat-saturated) images in 23/31 (74.2%) patients. Twenty-one lesions of the TFCC and intrinsic ligaments were visualized on noncontrast-sensitive (MPGR and STIR) images (15 tears of the TFCC and six tears of the SLL and LTL). All of these lesions were seen on T1 fat-saturated images; 48.8% (20/41) lesions seen on T1 fat-saturated images (eight tears of TFCC and 12 tears of SLL and LTT) were not seen on MPGR and/or STIR images. Superior contrast resolution, joint distention, and the flow of contrast facilitate the diagnosis of lesions of the TFCC and intrinsic ligaments on contrast-sensitive sequences making MRA the preferred modality for imaging internal derangements of the wrist. Little agreement exists regarding the value and location of perforations of the intrinsic ligaments given that both traumatic and degenerative perforations may be symptomatic. Noncommunicating defects of the ulnar attachments of the triangular fibrocartilage (TFC), tears of the dorsal segment of the SLL, and defects at the lunate attachment of the SLL have a higher likelihood of being symptomatic and caused by trauma rather than by degenerative perforation. Although no consensus exists, it would appear that most arthrographies should be started with a radiocarpal injection. Injection into the distal radioulnar joint should be added if no communicational defects are visualized following radiocarpal injection in patients with ulnar-sided wrist pain.

show abstract

“…Mucoid degeneration of the carpal ligaments and the TFCC is a physiologic aging process that begins as early as the age of 30 years [44,47]. Degenerative perforations are frequently found in the middle SLL and LTL segments.…”

Section: Kinematography (Cr)mentioning

confidence: 99%

“…In the elderly patient population, there is only a loose correlation between clinical and arthrographic findings [45,48]. Therefore, it is recommened to combine wrist arthrography with a subsequent magnetic resonance imaging (MRI) or computed tomography (CT) examination [47,[49][50][51][52] to better assess the altered ligament segments (Figs. 5c,d, 6).…”

Section: Kinematography (Cr)mentioning

confidence: 99%

Carpal instability

et al. 2006

View full text Add to dashboard Cite

This review addresses the pathoanatomical basics as well as the clinical and radiological presentation of instability patterns of the wrist. Carpal instability mostly follows an injury; however, other diseases, like CPPD arthropathy, can be associated. Instability occurs either if the carpus is unable to sustain physiologic loads ("dyskinetics") or suffers from abnormal motion of its bones during movement ("dyskinematics"). In the classification of carpal instability, dissociative subcategories (located within proximal carpal row) are differentiated from non-dissociative subcategories (present between the carpal rows) and combined patterns. It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being "occult" for the radiologic assessment. This paper emphasizes the high utility of kinematographic studies, contrast-enhanced magnetic resonance imaging (MRI) and MR arthrography for detecting these predynamic and dynamic instability stages. Later in the natural history of carpal instability, static malalignment of the wrist and osteoarthritis will develop, both being associated with significant morbidity and disability. To prevent individual and socio-economic implications, the hand surgeon or orthopedist, as well as the radiologist, is challenged for early and precise diagnosis.

show abstract

Wrist MR Arthrography: How, Why, When

Cited by 87 publications

References 92 publications

Evaluation of the triangular fibrocartilage in cadaveric wrists by means of arthrography, magnetic resonance (MR) imaging, and MR arthrography

Evaluation of the triangular fibrocartilage in cadaveric wrists by means of arthrography, magnetic resonance (MR) imaging, and MR arthrography

MR Arthrography of the Wrist: Controversies and Concepts

Carpal instability

Contact Info

Product

Resources

About